SynthesisSystematic reviews2012
Auto-titrating versus fixed continuous positive airway pressure for the treatment of obstructive sleep apnea: a systematic review with meta-analyses.
Synthesis in Systematic reviews, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
48 citing papers in PubMed, 3 syntheses or guidelines pooled it, 147 citations in OpenAlex.
- Long-term effects on clinical event, mental health, and related outcomes of CPAP for obstructive sleep apnea: a systematic review.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2024Pooled it
- Pressure modification or humidification for improving usage of continuous positive airway pressure machines in adults with obstructive sleep apnoea.The Cochrane database of systematic reviews · 2019Pooled it
- Pooled it
- Effects of Pressure Control Device (SensAwake™) on Obstructive Sleep Apnea (OSA) Patients Who Remove the Mask for Unknown Reasons during Automatic Continuous Positive Airway Pressure (Auto-CPAP) Therapy: A Prospective Randomized Crossover Trial.Medicina (Kaunas, Lithuania) · 2021Trial
- Comparison of Auto- and Fixed-Continuous Positive Airway Pressure on Air Leak in Patients with Obstructive Sleep Apnea: Data from a Randomized Controlled Trial.Canadian respiratory journal · 2019Trial
- A Randomized Crossover Trial Comparing Autotitrating and Continuous Positive Airway Pressure in Subjects With Symptoms of Aerophagia: Effects on Compliance and Subjective Symptoms.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2017Trial
- Validation of the System One RemStar Auto A-Flex for Obstructive Sleep Apnea Treatment and Detection of Residual Apnea-Hypopnea Index: A European Randomized Trial.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2017Trial
- Randomised short-term trial of high-span versus low-span APAP for treating sleep apnoea.Sleep & breathing = Schlaf & Atmung · 2016Trial
- Auto-adjusting positive airway pressure treatment for sleep apnea diagnosed by home sleep testing.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2014Trial
- Impact of treatment with continuous positive airway pressure (CPAP) on weight in obstructive sleep apnea.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2013Trial
- Chinese Guidelines for the Diagnosis and Surgical Treatment of Adult Obstructive Sleep Apnea (2024).World journal of otorhinolaryngology - head and neck surgery · 2026Article
- Evaluation of apap parameters in one to three nights titration for final pressure decision-making in a real world clinical setting.Sleep & breathing = Schlaf & Atmung · 2026Article
- Impact of Pressure Variability and Comorbidities on PAP Therapy Compliance and Adherence in Obstructive Sleep Apnea.Life (Basel, Switzerland) · 2025Article
- Auto-adjusting positive airway pressure: the fine line between engineering and medicine.Sleep & breathing = Schlaf & Atmung · 2025Review
- Normalisation of AHI Under Positive Pressure Therapy Does Not Necessarily Mean Control of Symptoms: A Comparison of the Effectiveness of APAP and CPAP on Daytime Sleepiness and Nocturnal Urination.Life (Basel, Switzerland) · 2025Article
- Association between the Monthly Visit Behavior and CPAP Adherence in OSAS Patients.Internal medicine (Tokyo, Japan) · 2025Article
- A comparative cloud-based view of adherence data over 1 year of CPAP versus APAP uses in OSA patients: Adherence depends on PAP device.Lung India : official organ of Indian Chest Society · 2025Article
- Long-Term Management of Sleep Apnea-Hypopnea Syndrome: Efficacy and Challenges of Continuous Positive Airway Pressure Therapy-A Narrative Review.Medical sciences (Basel, Switzerland) · 2024Review
- The Role of Telemedicine in Children with Obstructive Sleep Apnea Syndrome (OSAS): A Review of the Literature.Journal of clinical medicine · 2024Review
- Factors associated with treatment adherence to mandibular advancement devices: a scoping review.Sleep & breathing = Schlaf & Atmung · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundObstructive sleep apnea is a relatively common disorder that can lead to lost productivity and cardiovascular disease. The form of positive airway treatment that should be offered is unclear.
methodsMEDLINE and the Cochrane Central Trials registry were searched for English language randomized controlled trials comparing auto-titrating positive airway pressure (APAP) with continuous positive airway pressure (CPAP) in adults with obstructive sleep apnea (inception through 9/2010). Six researchers extracted information on study design, potential bias, patient characteristics, interventions and outcomes. Data for each study were extracted by one reviewer and confirmed by another. Random effects model meta-analyses were performed for selected outcomes.
resultsTwenty-four randomized controlled trials met the inclusion criteria. In individual studies, APAP and fixed CPAP resulted in similar changes from baseline in the apnea-hypopnea index, most other sleep study measures and quality of life. By meta-analysis, APAP improved compliance by 11 minutes per night (95% CI, 3 to 19 minutes) and reduced sleepiness as measured by the Epworth Sleepiness Scale by 0.5 points (95% CI, 0.8 to 0.2 point reduction) compared with fixed CPAP. Fixed CPAP improved minimum oxygen saturation by 1.3% more than APAP (95% CI, 0.4 to 2.2%). Studies had relatively short follow-up and generally excluded patients with significant comorbidities. No study reported on objective clinical outcomes.
conclusionsStatistically significant differences were found but clinical importance is unclear. Because the treatment effects are similar between APAP and CPAP, the therapy of choice may depend on other factors such as patient preference, specific reasons for non-compliance and cost.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.